Individual
DR. JASON B. WYNBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 227-6008
Mailing address
3 UNIVERSITY PLZ STE 205, HACKENSACK, NJ 07601-6208
(201) 833-3599
(201) 227-6207
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
240026
NY
208800000X
Urology Physician
Primary
25MA10611400
NJ
208800000X
Urology Physician
4301086135
MI
208800000X
Urology Physician
BW9323382
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02759039
—
NY
01
—
P1388005
OXFORD
NJ
05
—
PENDING
—
NJ
Enumeration date
11/15/2005
Last updated
08/09/2024
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